Submit applications to
UNCE-Lyon CountyOffice
504 SMainSt.
Yerington,NV 89447
LYON COUNTY 4-H LEADERS’ COUNCIL
SCHOLARSHIP APPLICATION FORM
Pleaselimitallresponsesas instructed.
- First,Middle,andLastName:
EmailAddress:
2.Age on January 1of this year:
Social Security Number must be submitted upon award of Scholarship.
3.Residence:
A.Home Address:
City, State, and Zip Code:
B.TelephoneNumber:
C.Place ofResidence(Check One)
Farm or Ranch
Townsunder10,000andruralnon-farm
Townsandcities(10,000-50,000),andtheirsuburbs
Suburbsofcitiesofover50,000
Citiesofover50,000
4.School Name:
Address ofSchool:
City, State, and Zip Code:
Date ofGraduation:
Scholastic Average:GradePointAverage based on 4.0 scale
5.Family:
A.Name ofFather:
Address:
City, State, and Zip Code:
B.Name ofMother:
Address:
City, State, and Zip Code:
C.Name of Guardian (ifno parent):
Address:
City, State, and Zip Code:
6.Listpaidand non-paid work experience/employment.Limitresponse to four lines of text.
EstablishmentSupervisor
7.Describe why you are interested inpursuing education beyond High School. Limitresponse to three lines of text.
8.What do you plan tostudy?Limitresponse to two lines of text.
9.Outline your reasons for choosing this fieldofstudy. Limitresponse to three lines of text.
10.Explain your need for financialassistance to continue youreducation and describe your plans for meeting this financialneed. Limitresponse to four lines of text.
A.Listanticipated collegecosts for the nextyear:
Tuition Fees: $
Room /Board: $
LabFees: $
Personal Expenses (includes clothingtransportation):$
Books: $
Other: $
11.4-H Information:
A.Number of yearsenrolled as a 4-H Member:
B.Have you workedin the concessionstandat theLyon CountyFairandRodeo orLyon County Junior Livestock Show?
Yes:
When:
No:
If so, how many hours did you work?
C.Have you worked in any other fund-raising endeavor offeredby the LyonCounty 4-H
Leaders’ Council?Ifyes,pleasegive the date anda description ofthe event. Limit response to three lines of text.
D. Past 4-H Projects completed. Limit response to four lines of text.
E.Current 4-H Projectsenrolled in. Limit response to four lines of text.
F.Major 4-H accomplishments/leadership roles in Nevada. Limit response to four lines of text.
G. Any major4-H accomplishments/leadership roles in otherstates(ifapplicable). Limit response to four lines of text.
H.Attach anadditionalsheet of paper to thisApplication Form.In 300words or less,please describe your involvement in 4-H and howthis has helped you preparegoals for your future.
12.Listbelowinterests,activities and communityservice. Limitresponse to four lines of text per item.
A.School
B. Community
C. 4-H
D. Religious
E. Special Interests/Hobbies
Signatures
Ihavepersonally prepared this application and believe it to be correct:
Signature of Applicant and Date:
Signature of Local 4-H Leader and Date:
Signature of Parent/Guardian and Date:
The UniversityofNevada,Reno is an Equal Employment Opportunity/Affirmative Action employer and doesnot discriminateon the basis ofrace,color, religion,sex,age,creed, national origin,veteran status, physical or mental disability,or sexual orientationin any program or activityitoperates.The UniversityofNevada employs onlyUnited States citizensand aliens lawfullyauthorized to work in the United States.
STATEMENTBY PRINCIPAL, COUNSELOR OR TEACHER
Signature, Title and Date:
UNCE-Lyon County
4-H Portfolio
SimpleGuidelines
“PuttingItAllTogether”
Junior(9-10yearsofageasofJanuary1stofcurrentyear)Portfoliosmustbehandwritteninblueorblackink, only.Computer generated portfolios willnotbe accepted for 4-H Juniors!
Intermediate(11-13yearsofageasofJanuary1stofcurrentyear)Membershavetheoptionofhandwriting (blueorblackink)ortyping/computergeneratingportfolios.Computergeneratedportfoliosareencouraged. Computerpagesmustfollowsameformatasoriginals.
Senior(14yearsandaboveasof January1stofcurrentyear)Membershavetheoptionofhandwriting(blueor blackink)ortyping/computergeneratedportfolios.Computergeneratedpagesmustfollowsameformatas originals.
1.COVER
Usethegreenregulation4-H8.5”X11”binder. ThiscanbepurchasedfromtheLyon County4-HLeaders’Council,attheUNCE-LyonCountyOffice.
2.TABLEOFCONTENTS
Haveadividerpagewithindex tab forall sectionswhethercomplete ornot. Typeor print(blueorblackink)thenameoftheprincipalsections(TableofContents,Annual Achievement Record, 4-H Story,4-HProjectRecords,JuniorandTeenLeaderPlanandReportsifapplicable,4-HMedia,Member’s Section,andpastyears4-Hrecords)ontheindextabs. Under 4-HProject Records, listeach project separatelyandusedividerpageswithindextabsforeach project. Includeonlycurrent4-HyearProject Recordshere; pastyearsshould be divided byyear bydividerpage/indextaband thelastitemin the portfolio.
NOTE-Dividerpages/indextabsshouldnotstickoutbeyondtheedgeofthebinder.Thesedivider index-tabpagesshouldbeblank!
3.Annual Achievement Record
This is a journal and an important account of your4-H career and otherevents occurring during this partofyour life.Presentation is a combination ofinformationand appearance.This journal will be veryusefultoyouin the future when collecting information for scholarships,job applications or writing resumes. Visitthe county4-H website toupload a copyofthis document[1].
NOTE– Ifyouhavenoinformation,ordidn’tparticipateintheindicatedactivity,inasectionof theAnnualAchievementRecordorProjectRecord(s)put“N/A”or“NotApplicable”inthe space.Thisindicatesyouhadnoresponse,asopposedtoforgettingtocompleteit.
4.4-HSTORY
The 4-HStoryisanintegralpart oftheportfolio;itshouldgivethereaderasenseofwho youare,beyondarecordoftheitemsyou’veexhibited andskillslearned. Itshouldfocusonthemain projectsinwhichyouaresubmittingyourportfolio;themajorityofthestoryshouldrelatetothecurrent 4-Hyear,butitmayencompasspreviousyears. Itshouldconveyhowparticipationin4-Hcontributes toyourself-respectandconcernforothers, influencedyouinschoolandinfluencedyouruseofleisure time and careerplans. REMEMBER:your storyislimitedtosix (6)type-writtendouble-spacedpagesat 12pt.fontandmustbehandwrittenif4-HJunior.
Thefollowingoutlinemayhelpyouindevelopingyourstory. It’sdividedintopartstohelpyououtlinewhatyou wanttosay.DO NOT identify these parts in yourStory.
Introduceyourself. Includeyourage,interests,parents,brothersand/or sisters,where youlive, whereyougoschool,whenandwhyyoujoined4-H.
Describethemajorproject(s)inwhichyouaresubmittinga4-HPortfolio.Relayhow4-Hhelped youlearnthingsaboutthissubject, howyour projectgrewinsizeandscopeandthingsyoutried (successfulornot).
Highlightother4-Hevents,activities orexperiences. Includemajorlearning opportunities, specialinterestsandunusualsituationsyouencountered.
Explainhow4-Hhelpedyoubecomeabetterleaderandcitizen. Howhas4-Hincreased your interestandparticipationinthecommunity,andwhathaveyoulearnedfromyoureffortsaspartofa 4-Hteam?
Describehow 4-Hparticipationhelpedyoufeelgoodabout yourself,influencedyourschooland careergoalsandhow4-Hhelpedyoutoinfluenceotherpeople.
5.PROJECTRECORDS
Includecurrentyear’sProjectRecordsintheorderlistedinthe Table of Contents. The UNCE-LyonCountyOfficehasProjectRecordsforallprojects.JuniorandTeenLeaders– includecompletedand signedPlan andReport!
6.4-HMEDIA
Containsthecurrentyear’s 4-Hclub, projector activity photographs (2, one-sidedpagesof photographsperenrolledprojectand/orclub,maximum), newsclippings(3,one-sidedpages, maximum) and correspondence(3itemsmaximum). Thereshouldbeatleastonepageofeachofthesethreetypesof media!
- Photographs – (2, one-sided pages of photographs per enrolled project and/or club, maximum).
Photographsshouldtellastoryorillustratepersonalgrowthwithappropriatecaptions. Actionshots andsequencesaregoodwaytoshowprogressinprojectorclubwork. Layeringisnot allowed. Mount photographswithrubbercementorphotomountingadhesive. Photographpagesmaybecreatedviaa computer software program,printed and placed inthis section.Photosshould be ofahigh quality.
EXCEPTION–Membersenrolledin photography,digitalmediaorsimilar projectsmay submit ten(10) additionalpagesofphotographsorpagesillustratingtheirProjectwork. MembersenrolledinFashion Review maysubmitthree (3) additional pagesofphotographsrelated to theirProjectwork.
- NewsClippings–(3,one-sidedpages,maximum)Nameofnewspaperanddateofarticlearerequired.Underlineorhighlightyourname. Mustbe4-Hrelatedarticles.Originalclippingsareencouraged. Online articles maybe printed from anonline news source.
c.Correspondence–(3,one-sidedpages,maximum)4-Hrelatedlettersaddressedtothe4-HMemberare allowed. Do notinclude copiesofletters youwrote,certificates or awards.
NOTE–Usewhitebiology,cardstock,orheavylb.paperasthebackingforphotographs,newsclippings or correspondence.
7.MEMBER’S SECTION
This section is for the member to express himself/herself inwhatever4-H appropriate manner they’d like. Itcould includeadditional photos, poems, stories, artwork (or photos of artwork),certificates, etc. Items containedin this section shouldn’textend beyond the boundaries ofthe cover; rememberoverallpresentation is an important partof the4-H Portfolio. Maximum of 3, single-sided pages for this section.
8.PAST YEARSPORTFOLIOS
Members shouldinclude completed past 4-H year’s portfolios.Additionalbindersmay be used,butyou should clearly identify the contents as those from past years.
Contactthe UNCE-Lyon CountyOffice for an expanded and moredetailed versionof these guidelines!
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